By: 25 September 2015

Identifying children at risk for sleep-disordered breathing prior to surgery

Knowing which risks may come into play before or during surgery is especially important where children are concerned. Implementation of a screening questionnaire detailed in the AANA journal helps anaesthesia professionals identify children with symptoms of sleep-disordered breathing (SDB) before undergoing a general anaesthetic.

The article, entitled ‘Snoring, trouble breathing, un-refreshed (STBUR) screening questionnaire to reduce perioperative respiratory adverse events in paediatric surgical patients: A quality improvement project’, featured in the August 2015 issue of the journal, published by the American Association of Nurse Anesthetists (AANA).

A main challenge to addressing SDB in children about to undergo surgery is the lack of awareness of the risks, and parents who underestimate their child’s condition. Lead author Karrey Terry says: “Parents are often unaware of the potential problems related to their child’s snoring. Recognition of this condition is of utmost importance, as children have died after routine tonsillectomies after receiving too much pain medication.”

Because SDB manifests itself in a patient’s respiration, anaesthesia professionals such as Certified Registered Nurse Anesthetists are in a perfect position to uncover undiagnosed conditions such as SDB prior to surgery in an effort to head off any respiratory complications during anaesthesia. The STBUR questionnaire provides five questions that help to identify SDB before surgery. The importance of identifying those at risk is paramount: the likelihood of developing a perioperative respiratory adverse event increases three-fold in the presence of any three STBUR symptoms, and by a factor of 10 when all five symptoms are present.

Including the questionnaire in the pre-anaesthesia interview raises awareness of potential risks, and allows anaesthesia professionals to modify their airway and anaesthesia plans toward safer practices.

“We are looking to improve safety by creating evidence-based standards of care,” says Terry.

Source: American Association of Nurse Anesthetists